Provider Demographics
NPI:1790010080
Name:MADISON HEALTH CARE PROPERTIES LLC
Entity Type:Organization
Organization Name:MADISON HEALTH CARE PROPERTIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-557-1190
Mailing Address - Street 1:7465 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-6564
Mailing Address - Country:US
Mailing Address - Phone:317-894-3301
Mailing Address - Fax:317-245-2510
Practice Address - Street 1:7465 MADISON AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-6564
Practice Address - Country:US
Practice Address - Phone:317-894-3301
Practice Address - Fax:317-245-2510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility